Background and Aims: This study was designed to compare the postoperative analgesic effect of dexmedetomidine administered intravenously or in wound infiltration with bupivacaine in patients undergoing caesarean section.
Methods: Ninety female patients scheduled for caesarean section randomly allocated into three equal groups: group 1 received 100 ml normal saline infusion over 10 minutes. before closure plus wound infiltration with 25 ml of 0.25% bupivacaine at the end of surgery, group 2 received dexmedetomidine 1 μg/kg in 100 ml normal saline infusion over 10 minutes before closure plus wound infiltration with 25 ml of 0.25% bupivacaine at the end of surgery and group 3 received 100 ml normal saline infusion over 10 minutes. before closure plus wound infiltration with dexmedetomidine 1 μg/kg added to 25 ml of 0.25% bupivacaine at the end of surgery. Statistical analysis was done by using ANOVA test for quantitative data and Chi- square or Fisher exact tests for qualitative data.
Results: Postoperative morphine consumption was significantly less in patients receiving dexmedetomidine by either route when compared with the control group. Visual analogue scale (VAS) was lower at rest for 6 hours and on cough for 4 hours post-operative in groups 2 and 3 when compared with group 1. Patients in group 2 had more hypotension and sedation compared with other groups.
Conclusions: Dexmedetomidine provided effective postoperative analgesia and reduced morphine consumption when administered IV or in wound infiltration with bupivacaine. The incidence of complications was reduced with wound infiltration.